Evaluation value of drug balloon therapy for intracranial atherosclerotic stenosis based on high-resolution vascular wall MRI / 中华放射学杂志

ABSTRACT

Objective:To explore the value of high resolution vascular wall MRI (VW-MRI) in drug balloon therapy of intracranial atherosclerotic stenosis.Methods:A total of 21 patients with intracranial atherosclerotic stenosis admitted to the First Affiliated Hospital of Shandong First Medical University from September 2019 to July 2021 were retrospectively analyzed, aged 22-73 (49±15) years, including 15 males and 6 females. All patients were treated with SeQuent Please drug coated balloon recanalization, and performed digital subtraction angiography (DSA), routine MRI and VW-MRI examinations within one week before operation and 2 to 3 months after treatment. The changes of atherosclerotic plaque area, length, enhancement index and stenosis degree before and after recanalization were evaluated. Paired t-test or Wilcoxon test was separately used to compare the difference before and after operation. The value of plaque characteristics in evaluating postoperative efficacy was analyzed by the receiver operating characteristic (ROC) curve. Pearson correlation analysis and Bland-Altman images method were used to test the correlation and consistency of VW-MRI and DSA in measuring the lumen stenosis degree. Results:After endovascular treatment with drug-coated balloon, the plaque area [(1.86±1.28)mm 2], length [3(2, 4)mm],enhancement index [(60±20)%] and lumen stenosis degree [(28±16)%] were significantly lower than those before endovascular treatment [(5.97±1.15)mm 2, t=10.93, P<0.001; 7(6, 9)mm, Z=-3.94, P<0.001; (107±46)%, t=4.26, P<0.001; (89±5)%, t=17.27, P<0.001]. The plaque area, length and enhancement index showed diagnostic value for evaluating the endovascular treatment efficacy (area under the ROC curve=0.89, 0.86, 0.74, respectively). Stenosis degree measured by VW-MRI had a positive correlation ( rpreoperative=0.66, P<0.001; rpostoperative=0.96, P<0.001) and consistency with DSA before and after recanalization. Conclusion:VW-MRI can be used to comprehensively and effectively evaluate treatment effect after endovascular treatment from the changes of plaque basic characteristics and stenosis degree, which is a good imaging follow-up tool.